Modified dental implant fixture

ABSTRACT

A modified dental implant fixture designed to preserve lingual bone by having the coronal aspect of the implant being compatible with bony anatomy that is higher on the lingual side of the implant surgical site. The implant may be of either the single stage or the two stage design. By modifying the shape of the top of the implant fixture to mimic healing/healed bony anatomy, bone is preserved and bone growth is possibly encourage.

CROSS-REFERENCE TO RELATED APPLICATION

[0001] This application is a continuation of U.S. application Ser. No.10/223,773, filed Aug. 19, 2002, which is a continuation-in-part, and,therefore, claims benefit under 35 U.S.C. §120, of U.S. patentapplication Ser. No. 10/011,866 filed Dec. 3, 2001.

BACKGROUND OF THE INVENTION

[0002] The present invention relates generally to dental implants, andmore specifically to a dental implant having an improved configurationto take advantage of the bone topography that is often present followingtooth extraction.

[0003] Dental implants are used in place of missing and/or extractednatural teeth as the base of support for an abutment and finalprosthesis in the attempt to restore normal oral function. Once teethhave been extracted, the alveolar bone at the extraction site heals andbegins to undergo resorption. The resorption process is halted byrestoring loading forces with a dental implant. The topographic changesof the alveolar bone have been described in the dental literature andare time dependent with regard to the amount of bone resorption. Whileimplants are designed to replace natural teeth, they must also bedesigned to consider the phenomenon of how bone heals and remodelsfollowing tooth extraction.

[0004] The implant body is surgically inserted in the patients jaw andbecomes integrated with the bone. More specifically, the implant body isscrewed or pressed into holes drilled in the respective bone. Thesurface of the implant body is characterized by macroscopic andmicroscopic features that aid in the process of osseointegration. Oncethe implant is fully integrated with the jaw bone, the abutment is readyto be mounted. For two-stage implant designs, the abutment passesthrough the soft tissue that covers the coronal end of the implant afterhealing and acts as the mounting feature for the prosthetic device to beused to restore oral function. Implants of the single-stage designextend through the tissue at the time of surgical insertion. The coronalend of the implant body acts as part of a built-in abutment design withthe margin of the coronal collar usually used as the margin for theattachment of the prosthesis used to restore oral function. Thesecomponents, the implant and abutment, are typically fabricated fromtitanium or an alloy of titanium as well as zirconia based, aluminabased or sapphire based ceramics. In some instances, ceramics and metalsare combined to make a single component, though this is usually limitedto the abutment component of the implant system.

[0005] One of the major problems associated with dental implants stemsfrom the failure to provide for the ideal alignment of implant fixturesin bone. Misalignment often results in the implant being positionedlingual to the ideal placement. Loosening or fracture of the abutmentsand even the implant body can result due to the adverse forces involved.Restorative dentists complain that the implants are not properly alignedby the surgeons, and the surgeons complain that the restorative dentistsdo not understand the challenges associated with the alignment process.

[0006] One of the most commonly placed fixture designs is the Branemarktype implant. These implants are ideally positioned in the approximatecenter line of the space where the extracted tooth was previouslypositioned. As with most traditionally designed implants, the Branemarktype fixture relies on a flat surface perpendicular to the long axis ofthe implant body for strength when joining the implant and the abutmenttogether. This design usually displays a bone loss pattern described asa cupping of the bone at the coronal end of the implant once loaded withocclusal forces. This cupping pattern usually stabilizes after about oneyear of function with vertical bone loss of approximately 2 mm but, bythat time, loss of bone critical to the predictable support of overlyingsoft tissue is lost.

[0007] Other implant systems often used are of the so called Astra Techand ITI Straumann type implants. These implant designs have an internalconical connector and do not rely on perpendicular orientation of a flatsurface for strength at the implant/abutment interface. Astra implants,due to or in combination with the rigid conical abutment connection andthe presence of coronal stress reducing micro threads on the implantbody, greatly reduce, and in some instances do not display theaforementioned bone loss patterns. However, the problem still exists asto the misalignment of such implants due to the flat topped coronalfeature of the implant body in its present configuration.

[0008] Astra Tech has addressed coronal bone loss by introducing microthreads at the coronal portion of the implant body to distribute forcestransferred to the surrounding bone. Other attempts to enhance implantdesigns have addressed bone loss patterns and lack of soft tissuesupport by focusing on the coronal aspect of the implant body in hopesof mimicking natural CEJ (cemento-enamel junction) anatomy or shapingthe implant body to be more root like in character. Implants duplicatingtooth anatomy in some way, shape or form have not had the same level ofsuccess as the Astra Tech concept. Unfortunately, once the tooth hasbeen extracted, the bone does not remember what the tooth looked like,or what function it provided. Implants must be designed as dentalimplants, not morphic copies of teeth. Even with the Astra's success,the design of the implant fixture and how that design interacts with thebony anatomy at the surgical site has not been addressed correctly. Todate, no design has considered the anatomy of how bone heals in thehuman jaw following tooth extraction.

[0009] Accordingly, it is a general object of the present invention toprovide an improved implant such that many of the problems related toimplant placement are eliminated.

[0010] It is another general object of the present invention toincorporate design features that take advantage of how bone heals.

[0011] It is a more specific object of the present invention to enableimplants to be placed in surgical sites of sloping bony anatomy moreprecisely and predictably.

[0012] Another object of the present invention is to preserve lingualbone by having the coronal aspect of the implant being compatible withthe bony anatomy that is higher on the lingual side of the surgicalsite.

[0013] It is another object of the present invention to provide forincreased strength of the implant/abutment system.

[0014] Yet another object of the present invention is to reduce theamount of time required by the restorative dentist to prepare andidealize the abutment.

[0015] Another object of the present invention is to reduce the numberof abutment orientation surfaces, thereby reducing the size requirementfor the implant body.

[0016] Still another object of the present invention is to make the useof snap on impression caps more useful and resulting in the finalprosthesis being more functional and cosmetic in appearance.

[0017] Yet another object of the present invention is to allow for asingle implant to be placed in the anterior region of the human jaw withpredictable soft tissue contours supported by bone.

[0018] Still another object of the present invention is to allowmultiple implants to be placed more predictably next to one another inthe anterior region of the human jaw.

[0019] Another object of the present invention is to combine thetwo-stage implant design having a length greatest on the lingual side ofthe jaw with an internal conical connection.

[0020] Still another object of the present invention is to modify thedesign of single stage implants to have features that enhance placementin sloping bony anatomy.

[0021] These and other objects, features and advantages of the presentinvention will be clearly understood through a consideration of thefollowing detailed description.

SUMMARY OF THE INVENTION

[0022] According to the present invention, there is provided a dentalimplant for implanting within a human jawbone, the jawbone havinglingual and buccal sides. The implant includes a generally cylindricallongitudinal body with an outer surface, an apical end and a coronalend. An abutment having a lower portion for connecting with the body.The coronal end is contoured such that when the implant is positionedwithin the jawbone the length between ends of the body is greatestwithin the lingual third of the jawbone.

BRIEF DESCRIPTION OF THE DRAWINGS

[0023] The features of the present invention, which are believed to benovel, are set forth with particularity in the appended claims. Theinvention, together with the further objects and advantages thereof, maybest be understood by reference to the following descriptions take inconjunction with the accompanying drawings, in the several figures ofwhich like reference numerals identify like elements, and in which:

[0024]FIG. 1 is a side view of the ideal implant placement within thejaw bone.

[0025]FIG. 2 is a side view of the ideal alignment of a typical implantburied within the jaw bone with sloping topographic anatomy to avoidfixture thread exposure.

[0026]FIG. 3 is a front view of a Branemark type implant design showingtypical cupping bone loss at the coronal aspect of the implant afterloading with functional forces.

[0027]FIG. 4 is a side view of the ideal alignment of a typical implantwithin the jaw bone with sloping topographic anatomy having threadsexposed on the facial aspect of the implant body.

[0028]FIG. 5 is a side view of the typical implant placed within thecenter of the maximum available bone height.

[0029]FIG. 6 is a side view of the preferred embodiment of the implantof the present invention.

[0030]FIG. 7 is an elevated side view of another embodiment of theimplant of the present invention with a small sized contoured abutmentattached coronally.

[0031]FIG. 8 is an elevated side view of another embodiment of theimplant of the present invention with a large sized contoured abutmentattached coronally.

[0032]FIG. 9 is an elevated front view of the preferred embodiment ofthe implant of the present invention.

[0033] FIGS. 10-12 are elevated side views of similar embodiments of thepresent invention.

[0034]FIG. 13 is a side view of the preferred embodiment of the implantof the present invention of the two stage type design with an abutmentdesigned to be used with snap-on impression caps.

[0035]FIG. 14 is a side view of the preferred embodiment of the implantof the present invention of the single stage type configured to be usedwith snap-on impression caps.

[0036]FIG. 15 is a front view of a Branemark type implant and associatedabutment design.

[0037]FIG. 16 is a side view of an Astra type implant and preferredembodiment associated abutment design.

DESCRIPTION OF THE PREFERRED EMBODIMENT

[0038] Dental implants are used in place of missing and/or extractednatural teeth as the base of support for an abutment and finalprosthesis in the attempt to restore normal oral function. Once a toothhas been extracted, the bone from which the tooth originated heals andis forever changed and probably continuously changing due to the forcesexerted on it. Dental implants need to be designed to take into accountthe natural healing process of bone.

[0039] Referring now to the Figures, and in particular FIG. 1, a typicalimplant 10 is illustrated implanted within the jaw bone 12. For purposedof describing the invention, the bone 12 of the human jaw will primarilybe discussed with respect to its lingual 14 and buccal 16 sides. Thisbone 12 illustrated by FIG. 1 is that of an ideal, but infrequentimplant site. That is, lingual side 14 and buccal side 16 bone appear tobe comparable in height and shape with respect to the center 18 of themaximum height of available bone. Therefore, the typical implant 10,with its flat top or coronal aspect 20 is suitable for its intendedpurpose when implanted within such a jaw bone condition.

[0040] However, when teeth are extracted, this ideal bone site of FIG. 1is seen more frequently in drawings from implant manufacturers ratherthan at the actual surgical sites encountered during surgical placementof implant fixtures. This is because the bone does not heal evenly oncea tooth has been extracted. It has been found that bone heals based onthe principles of bone biology and surrounding bony anatomy, surroundingbony and soft tissue anatomy as well as blood supply to the area. To adegree, bone healing and/or remodeling is influenced by the placementand subsequent loading of an implant fixture in the area of theextracted tooth or teeth. A number of studies have been conductedregarding bone loss patterns following tooth loss. One such outstandingstudy, by Cawood and Howell was published in the International Journalof Oral and Maxillofacial Surgery in 1991.

[0041] This study analyzed patterns of alveolar bone resorption from asample of 300 dried skulls with edentulous jaws. In general, bone lossis four times greater in mandible than the maxilla. One can construefrom this study that the highest point of bone anatomy is at the lingualside of extracted teeth after healing for a time period even as short asseveral months. Due to the natural bony contours in the anterior area ofthe upper and lower jaws, this healing pattern, often referred to asfacial collapse of bone, is more immediate than in the posterior upperand lower jaws. If an implant fixture is placed in the center of themaximum height of available bone, the implant can end up too far to thelingual from the point of view of the restorative dentist.

[0042] To avoid this overly lingual placement, implants can be submergedeven to the facial level of bone. FIG. 2 is illustrative of such asubmersion as the implant 22 is shown with its coronal aspect 20 fullysubmerged on the lingual side 14 and even with the bone 12 on the buccalside 16. The crown 24 to be attached to the abutment is then affixed tothe coronal aspect 20 in an attempt to restore normal oral function. Assuch an implant needs to be buried within the bone to compensate for theshape of the healing bone, the implant 22 must be significantly shorterin length than the ideal size shown in FIG. 1. This results in a weakerand less stable implant/abutment complex.

[0043] Another problem with burying implants is illustrated by FIG. 3.This Figure shows a typical Branemark type implant 26 which waspreviously buried within the bone 12 as discussed above. After theimplant has been affixed with an abutment and crown, the loading forcestypically produce a bone loss pattern referred to as cupping 28. Thisbone loss usually exposes the threads 30, and, essentially, results inthe placement of what amounts to be a shorter implant and thus a weakerimplant in the jaw bone.

[0044] Another way to avoid overly lingual implant placement isillustrated by FIG. 4. Here, the implant 10 has been inserted into thebone 12 with the proper alignment (as it had in FIG. 2), but now theimplant is protruding due to the sloping bony anatomy. Maximum height ofavailable bone was engaged, but exposed threads 32 compromise the idealfacial contour of the final restoration.

[0045] While the positioning of the implant is improved by burying orprotruding same, supporting bone is compromised in one instance (FIG. 2)and poor gingival profile results within the other placement (FIG. 4).In an attempt to avoid these problems in the mandible, surgeons may optto misalign the implant by angling its position as shown in FIG. 5.Here, the implant is angled towards the lingual to avoid perforating thelingual plate of bone 34. In other words, the implant 10 is placed inthe middle of the highest point of bone 36 lingual to where the missingtooth was previously positioned. Thus, this kind of positioning maycreate the greatest problem for the restoring dentist as he now mustattempt to esthetically and functionally position the crown 24 andabutment.

[0046] Proper alignment of the dental implant is essential to theesthetics as well as the mechanics of proper oral function. If theabutment and crown are affixed to a misaligned implant, the tooth notonly looks unattractive, but it will not be able to function properly asunfavorable loading forces will exist. Referring back to FIGS. 1-5, FIG.1 shows a properly aligned implant 10 and thus and thus a properlyaligned crown 24. FIGS. 2 and 4 show proper alignment of the implant,but demonstrate other problems previously described. Finally, FIG. 5shows an improperly aligned implant and thus a crown affixed to thebuccal of the implant fixture.

[0047] Additionally, the type of abutment connection incorporated intothe implant design, i.e. the Branemark design of FIG. 3 or the Astradesign of FIGS. 1-2 and 4-5, results in implants having decidedlydifferent clinical characteristics. In particular, and referring to FIG.15, the connection between the implant body 100 and the abutment 102 ofa two-stage implant of the Branemark design is characterized by a slipjoint connection, using an external hex 104 on the coronal end of theimplant in connection with the internal hex 106 of the abutment, andflat matting surfaces 108 between the abutment 102 and the implant 100which are perpendicular to the long axis of the implant. These flatsurfaces limit the joint connection as the parts come together. The slipfit joint typical of the Branemark and other flat matting platformdesigns result in a tipping action 110 causing loading stress patterns112 on one side and strain patterns 114 on the other side of the implantbody, because the outer edge 115 to the flat platform 108 acts as amechanical fulcrum point. It is hypothesized that when thisstress/strain on the coronal surface of the implant body is transferredto the surrounding bone, cupping (previously discussed) bone lossoccurs.

[0048] By contrast, the Astra-type implant uses what is referred to as aconical connection which is characterized by the male 116 and female 118cones of FIG. 16. The typical taper 120 for the connection of thesecoronal extension components range, but are not limited to, from about 5to 30 degrees. The degree of taper is one factor that determines theextent the two components are swagged together when the connection boltis threaded through the bolt hole of the abutment 122 and the threadedhole of implant 124 and tightened. The swagged fit becomes a cold weldas far as the implant 126 and the abutment 128 connection are concerned.This eliminates micro movement and distributes the stress/strain farmore favorably at the coronal end of the implant body. The mattingsurfaces of this conical connection need no flat joint limiting surfacesperpendicular to the long axis of the implant body because the male andfemale mating surfaces and the joint limiting surfaces are one in thesame. Upon off axis loading forces this type of abutment-fixture jointdistributes stress 130 more evenly within the joint itself avoiding peakloading moments and resulting in a tight and bio-mechanically stableconnection.

[0049] Since the Astra Tech type implants do not have a flat coronalaspect that is integral to the abutment connection, it is possible toshape the coronal contours to mimic healing/healed bony anatomy at theimplant surgical site. Additionally, because Astra Tech implants do notloose coronal bone as do the Branemark type implants, it is possible topreserve and possibly encourage slight bone growth in the coronaldirection. By preserving lingual bone height, bone mesial and distal tothe implant will also be maintained because, according to studies,including Cawood and Howell, bone slopes apically from the lingual.Preserve the lingual bone, and more bone adjacent to the implant on themesial and distal sides will be preserved. This is critical ifpredictable soft tissue papilla overlying these hard tissue sites is tobe generated or maintained. It has been shown that only 4 mm of papillaheight over mesial and distal bone is considered a level that therestorative dentist can rely on being generated time and again. Withoutsurrounding esthetic papilla, even the most perfectly contoured crown isunsightly in the upper anterior region of the mouth.

[0050] Accordingly, the present invention will be described as itrelates to the Astra type swagged implant. In particular, thecombination of the conical connection and the incorporation of stressdistributing micro threads/grooves in the coronal aspect of the implantin addition to surface texturing seem to be the primary design factorspreventing “cupping” bone loss from occurring. In its broadest aspects,the design modification of the present invention comprises a revisedangle of slope 132 of both the implant and abutment. This revisionextends to the abutment contour 134 as well. It will be appreciated thatin order for the sloped design modification to be of any value, theproblem of “cupping” bone loss must be overcome. The implant designcannot significantly modify the bony topography/anatomy once the implantis loaded. Secondly, the basic design has to be such that it can in factbe modified to incorporate alternate coronal contour to mimic how boneheals following tooth loss. Thus the basic design of the two stage Astraimplant allows not only for this modification, but for this modificationto be effective.

[0051] The preferred embodiment of the present invention is illustratedby FIG. 6. The implant 40 is a cylindrical longitudinal structuredesigned for bone 42 engagement. The typical length 82 (FIG. 9) of thepreferred embodiment is much like the currently used implants. Thatbeing between 9 to 18 mm base 84 to top 86 (FIG. 1) while the typicaldiameter is between 3 to 6.5 mm base 84 to top 86. The body of theimplant 40 is preferably, but need not be, comprised of screw threads 46to aid in the implantation process. The lower (apical) portion 48 of theimplant body includes larger threads 46 a than the smaller threads 46 bof the upper (coronal) portion 50. It has been found that the smallerthreads 46 b significantly reduce stress forces transmitted to bone andhelps to preserve cortical bone. They also increase the fixture strengthby adding wall thickness without changing the outer dimension of theimplant, compared to larger and deeper threads in the same area of theimplant. (These deep threads of current practices tend to dig into thebody of the implant and weaken it). However, other means may be used onthe outside surface of the implant 40 affixed to the implant within thebone 42, so long as the apical end 44 thereof is securely anchored. Thesurface of the implant 40 may be textured/coated in differing ways topromote osseointegration.

[0052] The coronal end 52 of the implant 40 accepts the base of theprosthetic abutment 54 using connection mechanisms of different designs.An example of such a design is the hex shape 56 shown on the implant 26of FIG. 3. While the commonly used internal hex or twelve positioninternal star design can be used, other options are now possible sincethe implant design has one vs. multiple orientations. Three to fivesided abutment alignment surfaces with from three to twelve internaldesigns are feasible; even one or two alignment surfaces are possible.Reducing the number of abutment orientation surfaces reduces the sizerequirements for this feature of the implant body. This is important indeveloping smaller fixtures suitable for use to replace lower anteriorteeth.

[0053] The basic concept of the present invention is the contouring orsloping of the coronal 52 or top of the implant fixture such thatlingual bone 14 is engaged and preserved. This coronal contour can be astraight line or a slightly convex contoured design so long as one boneengaging side 56 of the implant body (which would become the linguallyoriented side of the implant fixture) is longer in the apical-coronalbone engaging dimension than any other apical-coronal bone engagingdimension. This apical-coronal dimension or lingual high point does notinclude any implant collar (if present), but only the bone engagingsurface of the implant since the invention primarily addresses bonepreservation with predictable soft tissue preservation being understoodto be dependent on maintaining underlying supporting bone. Biomechanicsare improved for the entire implant 40 abutment 54 and crown 24 complex.Soft tissues 58 are much more predictable since underlying support boneis preserved.

[0054] Surgeons will be much less inclined to place fixtures at themiddle of the maximum height of available bone which is often to thelingual of the desired implant position (see FIG. 5). The slopingsurface of the coronal 52 makes it much more likely that placement inthe center of the space formerly occupied by the missing tooth will bepossible. Because the lingual aspect of the implant 40 can be placedmore coronally without the compromise inherent with flat top designs(See FIGS. 2-5), a more favorable implant fixture to prosthesis ratioresults which improves stress distribution. Furthermore, the design ofthe present invention does not reduce the strength of the implant, butin fact makes it stronger by extending the lingual side of the fixturecoronally. The implant fixture, when surgically placed, is longer by theheight of the lingual coronal extension, but is not placed deeper in thejaw bone.

[0055] Referring now to FIG. 7, the abutment 54 design simulates orfollows natural tissue contours 58 because of the coronal sloping 52feature of the implant. This dramatically reduces the amount of timerequired by the restorative dentist to prepare and idealize theabutments. Similarly, FIG. 8 shows a contoured abutment 60 of a largersize, which may be more suited for a molar tooth. In any event, thedesigns of FIGS. 7 and 8, or any similar designs that have tissue orgingival contour to take advantage of the coronal contour of the implantbody, will enable the restorative dentist to idealize final marginplacement rapidly.

[0056] The contouring or sloping of the coronal 52 or top of the implantfixture may best be illustrated by FIG. 9. Here, the differentialbone-engaging surface of the implant 40 is shown with respect to itsbuccal length (L₁) 80 in comparison to its lingual length (L₂) 82. Whilethe preferred contour may differ from patient to patient, preferably theheight differential (L₂−L₁) 88 is between 1 and 4 mm, more preferablythis differential 88 is between 2 and 3 mm. Therefore, as is shown, thebone-engaging surface, or the outer surface of the implant which is incontact with the jaw, of the implant 40 is longer on one side (lingual)than the other. With such a shape, bone preservation throughout the jawis achieved.

[0057] The coronal end 50 of the implant body 40 is preferablycharacterized by textured grit blasting 62, (or acid etching, plasmaspray technique, etc.) with or without micro threads/grooves 46 b asshown in FIG. 10. If micro threads/grooves are evident, they may beperpendicular (FIG. 10) to the long axis 64 of the implant 40, orparallel to the sloped (FIG. 11) or convex (FIG. 12) coronal contour 52.Having the micro threads/grooves 46 b parallel to the coronal contour 52as in FIGS. 11 and 12 may further aid in bone preservation and possiblycoronal bone apposition.

[0058]FIG. 13, like FIGS. 6-12, illustrates a design of the presentinvention as it relates to a two-stage type implant. The body 40 of theimplant is widest at the most coronal bone engaging aspect 66 andnarrows moving apically before having parallel walls 68 in the apicalhalf of the fixture. This inward coronal feature allows for thicker bonesurrounding the implant coronally, while at the same time creatingadequate coronal width to resist mechanical occlusal loading. Thetwo-stage design of FIG. 13 takes advantage of the sloped coronalsurface 52 and enables the use of a snap-on impression caps. Theseimpression caps engage the undercut 70 of the abutment margins.

[0059]FIG. 14, unlike FIGS. 6-12, illustrates a design of the presentinvention as it relates to a single stage type implant. This implant 72also incorporates the sloped coronal 74 contours of the aforementioneddesigns. All advantages that apply to the two stage implant design applyto this design as well. A machined collar 76 coronal to the microthreads 46 b and/or the textured surface 62 does not engage bone (thenon-bone engaging surface of the implant) and passes through the softtissue 78. This design allows for snap on impression caps (as describedabove) deemed essential to single stage designs. The perfect alignmentafforded to the implants of FIGS. 13 and 14, due to the sloping coronal52, provide for the perfect environment for snap-on impression caps.

[0060] Whether utilizing a single stage or a two-stage type implant, thebasic methodology for the surgeon remains the same. First, the implantsite is chosen. Next, taking into account the chosen site, the physicaldesign for the shape and size for the implant is chosen. This isdependent upon the remaining jawbone shape and size as well as otherfactors. This design will include overall length as well as coronaldifferential, among others. Now, the surgeon positions the implantwithin the bone.

[0061] The present invention provides for more latitude to the surgeonwith respect to placement of these implants. For example, singleimplants placed in the esthetic zone (upper anterior) will be much morepredictable in outcome since soft tissue supporting bone mesial anddistal of the implant body is preserved since bone on the lingual aspectof the fixture is not sacrificed or compromised. Similarly, the fixturedesign allows multiple implants to be placed in the esthetic zone,including implants placed next to one another. Since inter-implant boneis essentially preserved by the height of the lingual bone which is notsacrificed or compromised, papilla are maintained in the spaces betweenfinal implant supported restorations.

[0062] While a particular embodiment of the invention has been shown anddescribed, it will be obvious to those skilled in the art that changesand modifications may be made therein without departing from theinvention in its broader aspects, and, therefore, the aim in theappended claims is to cover all such changes and modifications as fallwithin the true spirit and scope of the invention.

I claim:
 1. A dental implant for implanting within a human jawbone, thejawbone having lingual and buccal sides, the implant comprising: agenerally cylindrical longitudinal body having an outer surface, anapical end and a coronal end; an abutment having a lower portion forconnection with the coronal end of said body; said body having a lengthdefined between said ends on said outer surface; and said coronal endbeing contoured such that when positioned within the jawbone said lengthis greatest in at least one dimension within the generally lingual onethird and shortest on the generally buccal side of said implant body. 2.A dental implant for implanting within a human jawbone, the jawbonehaving lingual and buccal sides, the implant comprising: a generallycylindrical longitudinal body having an outer surface, an apical end anda coronal end; an abutment having a lower portion for connection withthe coronal end of said body; said body having a length defined betweensaid ends on said outer surface; and said coronal end being contouredsuch that when positioned within the jawbone said length is greatest inat least one dimension within the generally lingual one third, equallygreatest in at least one dimension within the mesial and distal middleone third and shortest on the generally buccal side of said implantbody.
 3. A dental implant having a generally lingual one third, agenerally mesial and distal middle one third, and a generally buccal onethird for implanting within a human jawbone, the jawbone having lingualand buccal sides, the implant comprising: a generally cylindricallongitudinal body having an outer surface, an apical end and a coronalend; an abutment having a lower portion for connection with the coronalend of said body; said body having a length defined between said ends onsaid outer surface; and said coronal end being contoured such that whenpositioned within said jawbone said length is greatest in at least onedimension within the generally lingual one third and shortest on thegenerally buccal side of said implant body.
 4. A dental implant having agenerally lingual one third, a generally mesial and distal middle onethird, and a generally buccal one third for implanting within a humanjawbone, the jawbone having lingual and buccal sides, the implantcomprising: a generally cylindrical longitudinal body having an outersurface, an apical end and a coronal end; an abutment having a lowerportion for connection with the coronal end of said body; said bodyhaving a length defined between said ends on said outer surface; andsaid coronal end being contoured such that when positioned within saidjawbone said length is greatest in at least one dimension within thegenerally lingual one third, equally greatest in at least one dimensionwithin the mesial and distal middle one third and shortest on thegenerally buccal side of said implant body.
 5. A dental implant forimplanting within the human jawbone, the jawbone having lingual andbuccal sides, the implant comprising: a generally cylindricallongitudinal body having an outer surface, an apical end, and a coronalend; an abutment having a lower portion for connection with the coronalend of said body; said body having a bone engaging surface definedbetween said ends; and said coronal end being contoured such that whenpositioned within the jawbone said textured or otherwise prepared boneengaging surface is greatest in at least one dimension within thegenerally lingual third and shortest on the generally buccal third ofsaid body.
 6. A dental implant for implanting within the human jawbone,the jawbone having lingual and buccal sides, the implant comprising: agenerally cylindrical longitudinal body having an outer surface, anapical end, and a coronal end; an abutment having a lower portion forconnection with the coronal end of said body; said body having a boneengaging surface defined between said ends; and said coronal end beingcontoured such that when positioned within the jawbone said textured orotherwise prepared bone engaging surface is greatest in at least onedimension within the generally lingual third, equally greatest in atleast one dimension within the mesial and distal middle one third andshortest on the generally buccal side of said implant body.
 7. A dentalimplant having a generally lingual one third, a generally mesial anddistal middle one third, and a generally buccal one third for implantingwithin a human jawbone, the jawbone having lingual and buccal sides, theimplant comprising: a generally cylindrical longitudinal body having anouter surface, an apical end and a coronal end; said body having alength defined between said ends on said outer surface; and said coronalend being contoured such that when positioned within said jawbone saidlength is greatest in at least one dimension within the generallylingual one third and shortest on the generally buccal side of saidimplant body.
 8. A dental implant having a generally lingual one third,a generally mesial and distal middle one third, and a generally buccalone third for implanting within a human jawbone, the jawbone havinglingual and buccal sides, the implant comprising: a generallycylindrical longitudinal body having an outer surface, an apical end anda coronal end; said body having a length defined between said ends onsaid outer surface; and said coronal end being contoured such that whenpositioned within said jawbone said length is greatest in at least onedimension within the generally lingual one third, equally greatest in atleast one dimension within the mesial and distal middle one third andshortest on the generally buccal side of said implant body.
 9. A dentalimplant as defined in any of claims 1-8, wherein said body includes atleast one size of grooves around said diameter on at least one portionof said body.
 10. A dental implant as defined in any of claims 1-8,wherein said body includes at least one size of ridges around saiddiameter on at least one portion of said body.
 11. A dental implant asdefined in any of claims 1-8, wherein said body includes at least onesize of threads around said diameter on at least one portion of saidbody.
 12. A dental implant as defined in claim 9, wherein said groovesare parallel with and generally adjacent to the contour of said coronalend.
 13. A dental implant as defined in claim 10, wherein said ridgesare parallel with and generally adjacent to the contour of said coronalend.
 14. A dental implant as defined in claim 11, wherein said threadsare parallel with and generally adjacent to the contour of said coronalend.
 15. A dental implant as defined in claim 9, wherein said groovesare perpendicular to the long axis of the implant body of said coronalend.
 16. A dental implant as defined in claim 10, wherein said ridgesare perpendicular to the long axis of the implant body of said coronalend.
 17. A dental implant as defined in claim 11, wherein said threadsare perpendicular to the long axis of the implant body of said coronalend.
 18. A dental implant as defined in claims 11 or 17, wherein saidthreads on said coronal part of the implant body have multiple leadingstarting points to allow synchronization with larger apical threads ofsaid implant body.
 19. A dental implant as defined in any of claims 1-6,wherein said implant abutment extends coronally with off axisangulation.
 20. A dental implant as defined in claims 7 or 8, whereinsaid coronal end is adapted to accept an abutment extending coronally.21. A dental implant abutment as defined in claim 20, wherein saidabutment extends coronally with off axis angulation.
 22. A dentalimplant abutment as defined in any of claims 1-6, or 19-21, wherein saidabutment's restorative margin is contoured to be most coronal on thelingual, shortest on the buccal and of intermediate height on the mesialand distal.
 23. A dental implant dental implant as defined in any ofclaims 1-6, or 19-21, wherein said abutment's restorative margin iscontoured to be most coronal on the mesial and distal, shortest on thebuccal and of intermediate height on the lingual.
 24. A dental implantas defined in any of claims 1-6, or 19-21, wherein said abutmentincludes margins adapted to engage an impression cap.
 25. A dentalimplant as defined in any of claims 1-8, wherein said coronal contour isstraight.
 26. A dental implant as defined in any of claims 1-8, whereinsaid coronal contour is convex.
 27. A dental implant as defined in anyof claims 1-8, wherein said coronal contour is scalloped.
 28. A dentalimplant as defined in any of claims 1-8, wherein said coronallycontoured surface is textured.
 29. A dental implant as defined in any ofclaims 1-8, wherein said coronally contoured end has a machined collarof not more than 2.0 millimeter.
 30. A dental implant as defined in anyof claims 1-8, wherein said coronally contoured end has an etched collarof not more than 2.0 millimeter.
 31. A dental implant as defined in anyof claims 1-8, wherein said coronally contoured end has a polishedcollar of not more than 2.0 millimeter.
 32. A dental implant as definedin any of claims 1-8, wherein said body narrows apically.
 33. A dentalimplant as defined in any of claims 1-8, wherein said body has threadson the apical portion of said body.
 34. A dental implant for implantingwithin the human jawbone, the jawbone having lingual and buccal sides,the implant comprising: a generally cylindrical longitudinal body havingan outer surface, an apical end and a coronal end; an abutment having alower portion for connection with the coronal end of said body; saidouter surface of said body having a textured or otherwise prepared boneengaging surface such that it is prepared to be greatest in at least onedimension within the generally lingual side and shortest on thegenerally buccal side; and said body having collar extending 1.0 to 5.0mm coronal to the textured or otherwise prepared bone engaging surfaceof said coronal end.
 35. A dental implant for implanting within thehuman jawbone, the jawbone having lingual and buccal sides, the implantcomprising: a generally cylindrical longitudinal body having an outersurface, an apical end and a coronal end; an abutment having a lowerportion for connection with the coronal end of said body; said outersurface of said body having a textured or otherwise prepared boneengaging surface such that it is prepared to be greatest in at least onedimension within the generally lingual side, equally greatest in atleast one dimension within the mesial and distal middle one third andshortest on the generally buccal side of said implant body; and saidbody having collar extending 1.0 to 5.0 mm coronal to the textured orotherwise prepared bone engaging surface to said coronal end.
 36. Adental implant having a generally lingual one third, a generally mesialand distal middle one third, and a generally buccal one third forimplanting within the human jawbone having lingual and buccal sides, theimplant comprising: a generally cylindrical longitudinal body having anouter surface, an apical end and a coronal end; an abutment having alower portion for connection with the coronal end of said body; saidouter surface of said body having a textured or otherwise prepared boneengaging surface such that it is prepared to be greatest in at least onedimension within the generally lingual third and shortest on thegenerally buccal side; and said body having collar extending 1.0 to 5.0mm coronal to the textured or otherwise prepared bone engaging surfaceto said coronal end.
 37. A dental implant having a generally lingual onethird, a generally mesial and distal middle one third, and a generallybuccal one third for implanting within the human jawbone having lingualand buccal sides, the implant comprising: a generally cylindricallongitudinal body having an outer surface, an apical end and a coronalend; an abutment having a lower portion for connection with the coronalend of said body; said outer surface of said body having a textured orotherwise prepared bone engaging surface such that it is prepared to begreatest in at least one dimension within the generally lingual onethird, equally greatest in at least one dimension within the mesial anddistal middle one third and shortest on the generally buccal side ofsaid implant body; and said body having collar extending 1.0 to 5.0 mmcoronal to the textured or otherwise prepared bone engaging surface tosaid coronal end.
 38. A dental implant having a generally lingual onethird, a generally mesial and distal middle one third, and a generallybuccal one third for implanting within the human jawbone having lingualand buccal sides, the implant comprising: a generally cylindricallongitudinal body having an outer surface, an apical end and a coronalend; said outer surface of said body having a textured or otherwiseprepared bone engaging surface such that it is prepared to be greatestin at least one dimension within the generally lingual one third andshortest on the generally buccal side; and said body having collarextending 1.0 to 5.0 mm coronal to the textured or otherwise preparedbone engaging surface to said coronal end.
 39. A dental implant having agenerally lingual one third, a generally mesial and distal middle onethird, and a generally buccal one third for implanting within the humanjawbone having lingual and buccal sides, the implant comprising: agenerally cylindrical longitudinal body having an outer surface, anapical end and a coronal end; said outer surface of said body having atextured or otherwise prepared bone engaging surface such that it isprepared to be greatest in at least one dimension within the generallylingual one third, equally greatest in at least one dimension within themesial and distal middle one third and shortest on the generally buccalside of said implant body; and said body having collar extending 1.0 to5.0 mm coronal to the textured or otherwise prepared bone engagingsurface to said coronal end.
 40. A dental implant as defined in any ofclaims 34-39, wherein said coronal end is prepared to have a straightprofile, perpendicular to the long axis of said implant body.
 41. Adental implant as defined in any of claims 34-39, wherein said coronalend is contoured to have a convex profile.
 42. A dental implant asdefined in any of claims 34-39, wherein said coronal end is contoured tohave a scalloped profile such that the overall length of the implant isshortest on the generally buccal one third and intermediate in length onthe generally lingual one third.
 43. A dental implant as defined in anyof claims 34-39, wherein said coronal end is contoured to be have astraight sloping profile that is shortest on the generally buccal onethird and longest on the generally lingual one third.
 44. A dentalimplant as defined in any of claims 34-39, wherein said body includes atleast one size of grooves around at least a portion of said body.
 45. Adental implant as defined in any of claims 34-39, wherein said bodyincludes at least one size of ridges around at least a portion of saidbody.
 46. A dental implant as defined in any of claims 34-39, whereinsaid body includes at least one size of threads around at least aportion of said body.
 47. A dental implant as defined in claim 44,wherein said grooves are parallel with and generally adjacent to thecoronal contour of the textured bone engaging surface.
 48. A dentalimplant as defined in claim 45, wherein said ridges are parallel withand generally adjacent to the coronal contour of the textured boneengaging surface.
 49. A dental implant as defined in claim 46, whereinsaid threads are parallel with and generally adjacent to the coronalcontour of the textured bone engaging surface.
 50. A dental implant asdefined in claim 46, wherein said threads are perpendicular to the longaxis of the implant body of said coronal end.
 51. A dental implant asdefined in claims 46, 49 or 50, wherein said threads on said coronalpart of the implant body generally adjacent to the coronal contour ofthe textured bone engaging surface have multiple leading starting pointsto allow synchronization with larger apical threads of said implantbody.
 52. A dental implant as defined in any of claims 34-37, whereinsaid implant abutment extends coronally with off axis angulation.
 53. Adental implant as defined in claims 38 or 39, wherein said coronal endis adapted to accept an abutment extending coronally.
 54. A dentalimplant as defined in claim 53, wherein said abutment extends coronallywith off axis angulation.
 55. A dental implant as defined in any ofclaims 34-37 or 52-54, wherein said abutment is designed to accept animpression cap.
 56. A dental implant as defined in any of claims 34-39,wherein said coronally contoured margins of said implant body aredesigned to accept an impression cap.
 57. A dental implant as defined inany of claims 34-39, wherein said body narrows apically.
 58. A dentalimplant as defined in any of claims 34-39, wherein said body has threadson the apical portion of said body.
 59. A dental implant as defined inany of claims 34-39, wherein said body includes at least one size ofgrooves or threads around said diameter on at least a portion of saidbody.
 60. A dental implant as defined in any of claims 1-8 or 34-39,wherein grit blasting, or other surface preparing treatment(s) designedto promote osseointegration is used to prepare all bone engagingsurfaces.
 61. A dental implant as defined in any of claims 1-8 or 34-39,wherein acid etching, or other surface preparing treatment(s) designedto promote osseointegration is used to prepare all bone engagingsurfaces.
 62. A dental implant as defined in any of claims 1-8 or 34-39,wherein laser etching, or other surface preparing treatment(s) designedto promote osseointegration is used to prepare all bone engagingsurfaces.
 63. A dental implant as defined in any of claims 1-8 or 34-39,wherein said coronal contour follows the Fibonacci Progression.